Greg Roche, Distalmotion - Accessible On-Demand Surgical Robot | LSI USA '25

Greg Roche  0:04  
So good to see everybody really quick. Just going to spend the next nine minutes talking about an update around Distalmotion Just for background. Distalmotion is a soft tissue robotics company based in Lausanne, Switzerland. We have CE approval, neurology, gynecology and general surgery, and just received Innova approval in October for our first indication in general surgery, which is in guenhernia. So generally speaking, and you can look at the mission behind me, we really believe that there's an access issue in soft tissue robotics. And I'll talk a little bit about the reason we believe we can solve that. But whether that's procedure, whether that's site of care, or if there are clinical or economic barriers, we try to really knock those down and create access to allow surgeons and patients to bring robotics into their their, you know, their site of care and their procedure. So from a paradox perspective, you can see on the on the left here, 2 million procedures done today. This is growing at an amazing pace. So about 5 million procedures by 2032 so really, there's, there's not enough, given what we have in the US market today, to allow everyone to have the right access. But the other piece of this is, is really this site of care for both surgeons and for patients and for systems, the ability to start to put patients in the right side of care for the right procedure is a big theme, and you can see the revenue attributed to ambulatory surgery centers by the year 2020, 30, you're looking at about 75 billion in annual revenue in that space. So you have both these huge tail winds that really have created this paradox, because right now, if you think about the robotics market, they're large mainframe robots available in the US, they're mobile. They bring a lot of complexity from a workflow perspective, and certainly they drive a really big cost premium. So why do we think we can solve thisDistalmotion? Small mobile footprint. And if you go back to the slide here, you can see it, small mobile footprint. You can move this room to room. I was in Zurich about a month ago, four different procedures, four different rooms. That is almost impossible with any robot that's on the market today. When you think about complexity of workflow, and there's there's really two things to think about here. When you introduce a robot into a clinical workflow, we we look at this, and if you look at the patient here, this is a standard laparoscopic workflow, which you're applying. What I think is the core essence of robotic which is fully wristed instrumentation that allows the surgeon to Suture, dissect and work in confined space with high dexterity. So that is the core essence of robotics, but you don't have to give up what you know. So the approach is very near to laparoscopic surgery. You can see the surgeon. And this is also very unique to Distalmotion. The surgeon is sterile, so they have the ability to choose, both clinically and economically, what is the best way to approach the patient. And when you think about the types of procedures that are being done in an outpatient H, O, P, D or ASC, these lower acuity, high volume surgeries, you really have to focus both on the best and most appropriate clinical approach, but also the most appropriate economic approach which we provide. And then finally, when you think about instinctive design, so we you know when you there are a lot of different things that go into the adaptation of a robot. You have to think about how quickly surgeons learn and can adapt the technology. We just published a study. It's 10 cases. Is really the only barrier from a surgical perspective, that doesn't matter if you have robotic experience or do not, we usually see teams implementing in under four minutes. So you know, again, when you're talking about these lower acuity, high volume surgeries, you have to be really, really efficient in what you do. I think one of the things that I really like is that the surgeons can bring what they love. So we are building a world class robot and five accessory instruments. The surgeons can pick and choose their visualization. They can pick and choose their advanced instruments, so stapling or energy, they can pick and choose how they approach the case and what they see that fits best for that patient at that site of care. So all. All of these things, we think we're really breaking down the barriers of robotics without losing that core essence. And then again, if you look here, another global stat on the growth in soft tissue robotics, again, I think at least for my learnings, what we're both the surgical community, this is a big part of education now. So if you go to a residency or fellowship program, no matter where you are in the world, there's likely, at least in these disciplines, robotic is going to be a part of it. I've actually heard really big institutions that haven't implemented this. This the first time they're not filling seats in fellowship programs because they don't have robotics as a core part of the curriculum. The other piece here, though, is, if you look from a US, inpatient versus outpatient, the procedure. So I mentioned our first indication was in guino hernia, the next two targeted indications for us will be cholecystectomy and hysterectomy. That's two and a half million procedures in the US, and you can see by the light blue bars, how much of that is done in the outpatient environment today. So this is really a blue ocean opportunity. Again, there's a lot of reasons why you can't implement larger mainframe robotics, including sterilizations, you know, form factor, space, size, complexity. Again, you need very sophisticated staff at times. When you put the surgeon back in the field, it reduces a lot of those barriers. From a sterilization perspective, we have a single use instrument platform so it allows you not to have to overdo or incur the burden of introducing multiple instrument sets. And that's probably one of the largest lessons I learned in orthopedics robotics, was it wasn't that that a surgeon or a physician owner or IDN didn't want the technology. Was how to implement it where they wanted it. That was usually the biggest barrier. So just an FYI and this, this is a little dated since we've submitted, but we've done over 1700 surgeries in Europe, zero reportable device related events. I think that just goes to the efficacy and safety of the product. I'm really proud of that step. But you can also see we're still what I would consider a very deliberate or limited launch until 2026 but in some major markets in the EU and Switzerland, France, Austria and Germany. And then you can see the types of procedures that we do. So we do low acuity and high high acuity procedures. But the biggest procedures that we do are directly linked to our indication expansion in the US, which I just mentioned, and we've used Europe for clinical and product development, for us, indication expansion, as I mentioned, and for commercial validation. So we know that we have a battle tested product when we brought it to the US. And then, as I mentioned, we're scaling up quickly. We've got some really nice early commercial traction and some sales of our first robots, which is fantastic. We'll continue to, as I mentioned, to drive indication expansion over the next probably seven quarters, to get to approvals in the full verticals of urology, gynecology and general surgery. And then we've established training centers in San Diego, Houston and Orlando to accommodate our Surgeon population and get product exposure done. So just in summary, you know, what is Dexter doing? It's really breaking down and allowing caregivers to have access to robotics regardless of where they perform the surgery and what surgeries they're doing, by applying a small and mobile footprint, creating a seamless or workflow open architecture and really an instinctive design that's designed around implementing into the workflow of the surgeon, instead of A surgeon implementing into the workflow of the robot. We've got a massive opportunity in front of us, and I really appreciate everyone's time and listening to me talk about this demotion for a few minutes. Thank you.